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Dear
Lisa,
I
look forward to receiving your news letter and receive
a lot of information from every one Thank you. I am now
wanting to know if you can help me as I have a bit of
a problem.
I
recently went to our family doctor regarding prostrate
problem that appears to be a family problem as both my
older brothers and my dad have got enlargement of the
prostate. I was wondering if you had any information regarding
this matter ie-any side effects if I have to have minor
surgery.
He
has given me the name of a specialist/professor to see
and I am a little concerned as to what the out come will
be. I am 51 at the moment and am a little concerned. My
doctor did say that I will not be able to ejaculate semen
any more after ti has been scraped but will still have
feelings. I presumed he meant that I will still have an
orgasm but nothing will come out but air.
I
am feeling a little down at the moment as I am not looking
forward to the prospect of not cumming My wife and I still
have a pretty good sex life and I am worried that will
diminish. I have purchased a few toys from you over the
past 2 years and we have a lot of fun with them. I will
be seeing the specialist JAN 17 2005. I know that it is
not giving you much time to reply but Deb, my wife suggested
that I eMail you seeing that I get a lot of info from
you. Have a merry Christmas and a happy new year and I
hope to hear from you real soon. Once again thank you
for being there for us to write to.
ROB
Australia
Hi
Rob,
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Lisa
S. Lawless, Ph.D., CEO
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To
answer your question and for the benefit of our readers
I thought I would do a bit of background information for
you and all of our male readers in addition to the treatment
options. However, before I list that information, I wanted
to let you know that there is an alternative herb that
many men have used with a high level of success in reducing
the size of their prostate.
Of
course you should speak about it with your physician before
using it, but I thought to mention it as many doctors
in my opinion of often too quick to recommend surgery
when alternatives are available. Below is the name of
the herb and information about it in addition to more
information on the prostate, the condition in which you
describe and traditional treatment options as well as
sexual side effects of surgery.
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Pygeum
Bark
Also
Known as: Pygeum africanum
Pygeum is an evergreen tree found in the higher
elevations of central and southern Africa. The bark
is used in the treatment.
In
what conditions might pygeum be supportive?
Benign
Prostatic Hyperplasia (BPH)
Historical
or traditional use:
The
powdered bark was used as a tea for relief of urinary
disorders. European scientists were so impressed
with reports of pygeum’s actions that they began
laboratory investigations into the active constituents
in the bark. This led to the development of the
modern lipophilic (fat soluble) extract used today.
How
much should I take?
The
accepted form of pygeum used in Europe for treatment
of BPH is a lipophilic extract standardized to 13%
total sterols (typically calculated as beta-sitosterol).
The recommended dose is 50-100 mg two times per
day. Pygeum should be monitored over at least a
six- to nine-month period to determine efficacy.
As is the case with all BPH treatments, close medical
supervision is of the utmost importance.
Extensive
research agrees with the long tradition of using
Saw Palmetto and Pygeum extracts together to improve
urine flow and prostate health. The misture of sterol
compounds in Pygeum naturally complement the prostate
support of Saw Palmetto.
Are
there any side effects or interactions?
Side
effects to the lipophilic extract of pygeum are
rare. In clinical studies, there were very rare
reports of mild gastrointestinal irritation in some
patients
.
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What
Is The Prostate Gland?
The prostate is a walnut-sized gland that forms part of
the male reproductive system. The gland is made of two
lobes, or regions, enclosed by an outer layer of tissue.
As
the diagram shows below, the prostate is located in front
of the rectum and just below the bladder, where urine
is stored. The prostate also surrounds the urethra, the
canal through which urine passes out of the body.
Scientists
do not know all the prostate's functions. One of its main
roles, though, is to squeeze fluid into the urethra as
sperm move through during sexual climax. This fluid, which
helps make up semen, energizes the sperm and makes the
vaginal canal less acidic.
Benign
Prostatic Hyperplasia:
A
common part of aging for a man is for the prostate gland
to become enlarged. Doctors call the condition benign
prostatic hyperplasia (BPH), or benign prostatic hypertrophy.
Normal
urine flow. Urine flow with BPH. As a man matures, the
prostate goes through two main periods of growth. The
first occurs early in puberty, when the prostate doubles
in size.
At
around age 25, the gland begins to grow again. This second
growth phase often results, years later, in BPH. Though
the prostate continues to grow during most of a man's
life, the enlargement doesn't usually cause problems until
late in life.
BPH
rarely causes symptoms before age 40, but more than half
of men in their sixties and as many as 90 percent in their
seventies and eighties have some symptoms of BPH.
As
the prostate enlarges, the layer of tissue surrounding
it stops it from expanding, causing the gland to press
against the urethra like a clamp on a garden hose. The
bladder wall becomes thicker and irritable. The bladder
begins to contract even when it contains small amounts
of urine, causing more frequent urination.
Eventually,
the bladder weakens and loses the ability to empty itself.
Urine remains in the bladder. The narrowing of the urethra
and partial emptying of the bladder cause many of the
problems associated with BPH.
Many
people feel uncomfortable talking about the prostate,
since the gland plays a role in both sex and urination.
Still, prostate enlargement is as common a part of aging
as gray hair. As life expectancy rises, so does the occurrence
of BPH. In the United States in 2000, there were 4.5 million
visits to a physician for BPH.
Symptoms
Many
symptoms of BPH stem from obstruction of the urethra and
gradual loss of bladder function, which results in incomplete
emptying of the bladder. The symptoms of BPH vary, but
the most common ones involve changes or problems with
urination, such as a hesitant, interrupted, weak stream
urgency and leaking or dribbling more frequent urination,
especially at night.
The size of the prostate does not always determine how
severe the obstruction or the symptoms will be. Some men
with greatly enlarged glands have little obstruction and
few symptoms while others, whose glands are less enlarged,
have more blockage and greater problems. Sometimes a man
may not know he has any obstruction until he suddenly
finds himself unable to urinate at all. This condition,
called acute urinary retention, may be triggered by taking
over-the-counter cold or allergy medicines. Such medicines
contain a decongestant drug, known as a sympathomimetic.
A
potential side effect of this drug may be to prevent the
bladder opening from relaxing and allowing urine to empty.
When partial obstruction is present, urinary retention
also can be brought on by alcohol, cold temperatures,
or a long period of immobility.
That
is why it is important for a man to tell their doctor
about urinary problems such as those described above.
In 8 out of 10 cases, these symptoms suggest BPH, but
they also can signal other, more serious conditions that
require prompt treatment.
These
conditions, including prostate cancer, can be ruled out
only by a doctor's exam. Severe BPH can cause serious
problems over time. Urine retention and strain on the
bladder can lead to urinary tract infections, bladder
or kidney damage, bladder stones, and incontinence. If
the bladder is permanently damaged, treatment for BPH
may be ineffective. When BPH is found in its earlier stages,
there is a lower risk of developing such complications.
Diagnosis
You
may first notice symptoms of BPH yourself, or your doctor
may find that your prostate is enlarged during a routine
checkup. When BPH is suspected, you may be referred to
a urologist, a doctor who specializes in problems of the
urinary tract and the male reproductive system. Several
tests help the doctor identify the problem and decide
whether surgery is needed. The tests vary from patient
to patient, but the following are the most common.
Digital
Rectal Exam (DRE)
This
exam is usually the first test done. The doctor inserts
a gloved finger into the rectum and feels the part of
the prostate next to the rectum. This exam gives the doctor
a general idea of the size and condition of the gland.
Prostate
Specific Antigen (PSA)
Blood
Test To rule out cancer as a cause of urinary symptoms,
your doctor may recommend a PSA blood test. PSA, a protein
produced by prostate cells, is frequently present at elevated
levels in the blood of men who have prostate cancer.
Rectal
Ultrasound
If there is a suspicion of prostate cancer, your doctor
may recommend a test with rectal ultrasound. In this procedure,
a probe inserted in the rectum directs sound waves at
the prostate. The echo patterns of the sound waves form
an image of the prostate gland on a display screen.
Urine
Flow Study
Sometimes the doctor will ask a patient to urinate into
a special device that measures how quickly the urine is
flowing. A reduced flow often suggests BPH.
Cystoscopy
In this exam, the doctor inserts a small tube through
the opening of the urethra in the penis. This procedure
is done after a solution numbs the inside of the penis
so all sensation is lost. The tube, called a cystoscope,
contains a lens and a light system, which help the doctor
see the inside of the urethra and the bladder. This test
allows the doctor to determine the size of the gland and
identify the location and degree of the obstruction.
Treatment
Options
The
following section describes the types of treatment that
are most commonly used for BPH.
Drug
Treatment
Over
the years, researchers have tried to find a way to shrink
or at least stop the growth of the prostate without using
surgery. The Food and Drug Administration (FDA) has approved
several drugs to relieve common symptoms associated with
an enlarged prostate.
Finasteride,
FDA-approved in 1992 (marketed under the name Proscar)
Dutasteride,
FDA-approved in 2001 (marketed as Avodart)
Terazosin
(marketed as Hytrin) in 1993
Doxazosin
(marketed as Cardura) in 1995
Tamsulosin
(marketed as Flomax) in 1997
Alfuzosin
(marketed as Uroxatral) in 2003
The
drugs act by relaxing the smooth muscle of the prostate
and bladder neck to improve urine flow and to reduce bladder
outlet obstruction.
Minimally
Invasive Therapy
Because
drug treatment is not effective in all cases, researchers
in recent years have developed a number of procedures
that relieve BPH symptoms but are less invasive than conventional
surgery.
Transurethral
Microwave Procedures
In May 1996, FDA approved the Prostatron, a device that
uses microwaves to heat and destroy excess prostate tissue.
In the procedure called transurethral microwave thermotherapy
(TUMT), the Prostatron sends computer-regulated microwaves
through a catheter to heat selected portions of the prostate
to at least 111 degrees Fahrenheit. A cooling system protects
the urinary tract during the procedure.
The
Targis System
Like the Prostatron, the Targis System delivers microwaves
to destroy selected portions of the prostate and uses
a cooling system to protect the urethra. A heat-sensing
device inserted in the rectum helps monitor the therapy.
Both procedures take about 1 hour and can be performed
on an outpatient basis without general anesthesia.
Neither
procedure has been reported to lead to impotence or incontinence.
Although microwave therapy does not cure BPH, it reduces
urinary frequency, urgency, straining, and intermittent
flow.
It
does not correct the problem of incomplete emptying of
the bladder. Ongoing research will determine any long-term
effects of microwave therapy and who might benefit most
from this therapy.
Transurethral
Needle Ablation
In
October 1996, FDA approved Vidamed's minimally invasive
Transurethral Needle Ablation (TUNA) System for the treatment
of BPH. The TUNA System delivers low-level radiofrequency
energy through twin needles to burn away a well-defined
region of the enlarged prostate. Shields protect the urethra
from heat damage. The TUNA System improves urine flow
and relieves symptoms with fewer side effects when compared
with transurethral resection of the prostate (TURP). No
incontinence or impotence has been observed.
Surgical
Treatment
Most
doctors recommend removal of the enlarged part of the
prostate as the best long-term solution for patients with
BPH. With surgery for BPH, only the enlarged tissue that
is pressing against the urethra is removed; the rest of
the inside tissue and the outside capsule are left intact.
Surgery
usually relieves the obstruction and incomplete emptying
caused by BPH. The following section describes the types
of surgery that are used.
Transurethral
Surgery
In
this type of surgery, no external incision is needed.
After giving anesthesia, the surgeon reaches the prostate
by inserting an instrument through the urethra. A procedure
called TURP (transurethral resection of the prostate)
is used for 90 percent of all prostate surgeries done
for BPH.
With
TURP, an instrument called a resectoscope is inserted
through the penis. The resectoscope, which is about 12
inches long and 1/2 inch in diameter, contains a light,
valves for controlling irrigating fluid, and an electrical
loop that cuts tissue and seals blood vessels.
During
the 90-minute operation, the surgeon uses the resectoscope's
wire loop to remove the obstructing tissue one piece at
a time. The pieces of tissue are carried by the fluid
into the bladder and then flushed out at the end of the
operation. Most doctors suggest using TURP whenever possible.
Transurethral
procedures are less traumatic than open forms of surgery
and require a shorter recovery period.
Another
surgical procedure is called transurethral incision of
the prostate (TUIP). Instead of removing tissue, as with
TURP, this procedure widens the urethra by making a few
small cuts in the bladder neck, where the urethra joins
the bladder, and in the prostate gland itself. Although
some people believe that TUIP gives the same relief as
TURP with less risk of side effects such as retrograde
ejaculation, its advantages and long-term side effects
have not been clearly established.
Open
Surgery
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The
Holistic
Wisdom
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